Long-term stone-free rates after flexible URS: Does the size of DJ stent affect the outcomes

Abstract

Objective: This study’s main goal was to evaluate the possible impact of different-sized double-J (DJ) stents on the pain and stone-free status following flexible ureteroscopic laser disintegration (fURS) of renal stones. Material and Methods: A total of 104 patients who underwent fURS for kidney stones were included in our study. In 51 patients, a 4.7 Fr DJ stent was used after stone fragmentation, while in the remaining 53 cases, a 6 Fr stent was chosen. Between the two groups, general pain symptoms were evaluated using a visual pain scale at the end of the first postoperative week. The stone-free status was evaluated using non-contrast computed tomography (NCCT) after three months following surgery. Success was determined by either the complete clearance of the stones or the presence of small stone fragments (<3 mm). Results: Using a visual pain scale, we compared the two groups’ overall reports of pain (4.02±1.10 vs 4.81±1.53, p=0.006). When we looked at the stone-free rates, the two groups were not significantly different in this regard (84.3% vs 74.5%, p=0.264). We found no statistically significant difference between the two groups in terms of postoperative fever, stent migration, or visits to the emergency room. Conclusion: In spite of the fact that larger diameter stents resulted in more pain complaints for patients, they did not alter the long-term stone-free rates appreciably, as evidenced by our findings. In order to reduce the occurrence of unpleasant symptoms, a 4.7 Fr double-j stent may be preferable over a 6 Fr stent following flexible ureteroscopic surgery. Keywords: Double-j stent diameter, renal stones, flexible ureterorenoscopy, stone free